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The light-sensitive tissue lining at the back of the eye. The retina converts light into electrical impulses that are sent to the brain through the optic nerve.

Results: 1 to 20 of 106

Treatments for acute central retinal artery occlusion (blockage of the blood supply to the retina of the eye)

Central retinal artery occlusion occurs when the blood supply to the inner part of the retina (the light sensitive layer inside the eye) is suddenly stopped. If the blockage is removed in time, and the blood supply returns to the retina, full recovery is possible. However, if the blockage is prolonged the retina dies. Various methods have been tried in an attempt to remove the blockage including massaging the eye, lowering the pressure inside the eye and dissolving clots with drugs. Which of these methods is best for re‐establishing the blood supply is not known and some of the treatments can be associated with serious adverse effects. This review did find two studies that suggested that the blood supply to the retina could be improved with the treatments they tested ‐ although vision was not shown to be improved with either method in the study population. These were, however, small studies and did have potential flaws so more research is still needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Laser photocoagulation for treating choroidal new vessels near the centre of the retina in people with high myopia

In people with high myopia (refractive error ‐6 diopters or worse) new blood vessels can grow under the retina of the eye (choroidal neovascularisation). For decades laser coagulation has been used to destroy lesions that are not central. This review found one small study, including 70 participants, which compared laser photocoagulation with no treatment for people with this disease. This study was inadequately reported and analysed, although it suggested a benefit with photocoagulation during the first two years of follow up. Another small study compared three laser wavelengths to achieve photocoagulation of the lesion, but actually had very little power to demonstrate a difference between them as only 27 participants were included. Therefore, despite its widespread use for many years, the amount of benefit achieved with photocoagulation and the possibility that it is maintained over the years remains unknown. Furthermore, these and other studies suggest that the enlargement of the laser scar could be a potentially vision‐threatening long‐term complication after two years, since it may cause the gradual occurrence of a blind spot in the centre of the visual field due to progressive atrophy of the retina.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Peripheral retinal ablation for threshold retinopathy of prematurity in preterm infants

Advances in perinatal medicine have led to increased survival of extremely low birth weight infants and an increase in the incidence of retinopathy of prematurity (ROP). This is a vascular proliferative disorder of the immature retina in premature infants that can result in impairment of vision and a high (> 47%) chance of blindness if untreated (threshold ROP). Normally the retina has a complete system of blood vessels by 40 weeks. Injury to the developing retinal capillaries occurring before or during birth and in the days following delivery stimulates new vascularization, which is the observable retinopathy. This can result in successful revascularization of the retina (regression of the ROP) or progression to neovascular membranes in the vitreous, subsequent scarring and retinal detachment. The incidence and severity of retinopathy is inversely related to gestational age. Treatment involves removal (ablation) of the part of the retina without blood vessels to preserve central macula vision. Cryoablation and laser techniques are used. The review authors identified two randomised trials involving 291 and 28 premature infants with threshold ROP, reported in the 1980s. Both used cryotherapy for peripheral retinal ablation, reducing the incidence of adverse ophthalmic outcomes. Unfavorable retinal structure at less than 12 months and in early childhood at 5½ years (234 infants) was reduced by some 18 to 20%. Therefore, the number of eyes with threshold ROP needed to treat (NNT) to avoid one unfavorable outcome is around five. The risk of poor visual acuity in early childhood was reduced from 63 to 51% (NNT 8).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Topical non‐steroidal anti‐inflammatory agents for diabetic cystoid macular oedema

We reviewed the evidence about the effect of non‐steroidal anti‐inflammatory drugs for diabetic cystoid macular oedema.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Pentoxifylline for diabetic eye disease

Diabetic retinopathy or eye disease is the leading cause of blindness in developed countries. Nowadays its treatment is based on the use of laser therapy. Since this is a procedure which destroys important cells in the eye, drug approaches have been developed to prevent or improve lesions in the eyes of diabetic people. Studies with the agent pentoxyfilline suggest this may have an important role in the outcome and progression of diabetic retinopathy.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Selenium supplementation to prevent short‐term morbidity in preterm neonates

Higher doses of selenium supplements may be able to reduce some complications for preterm babies, but more research is needed. Selenium is an essential trace element gained from nutrients. Babies are born with lower selenium concentrations in their blood than their mothers. In very preterm babies, low selenium is associated with an increased risk of complications. The review of trials of selenium supplementation for preterm babies found that it reduces sepsis (blood infection). It has not been shown to reduce other complications or increase survival. No adverse effects were reported. Higher than usual levels of selenium supplementation may be beneficial, but more research is needed as most of the evidence comes from a country where selenium levels were unusually low.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

D‐Penicillamine for preventing retinopathy of prematurity in preterm infants

Retinopathy of prematurity (ROP) is an eye disease of premature infants that continues to be a serious problem. The drug D‐penicillamine, given by mouth, is commonly used to treat poisoning by iron or copper or other heavy metals. In research studies of D‐penicillamine used for another problem that premature infants have (high bilirubin), it was observed that the treated infants had less ROP. However, this systematic review did not show any significant benefits of this drug for the outcomes of ROP, death or development of nerves. Thus, the use of this drug cannot be recommended for the prevention of ROP based on available evidence.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Restricted versus liberal oxygen exposure for preventing morbidity and mortality in preterm or low birth weight infants

Restricting oxygen supplementation significantly reduces the rate and severity of vision problems (retinopathy) in premature and low birth weight babies. Babies born either prematurely (before 37 weeks) or with a low birth weight often have breathing problems and need extra oxygen. Oxygen supplementation has provided many benefits for these babies but can cause damage to the eyes (retinopathy) and lungs. The review of trials found that unrestricted oxygen supplementation has these potential adverse effects without any clear benefits. Restricted oxygen significantly reduces these risks. More research is needed to find the best level of oxygen supplementation.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Permissive hypercapnia for the prevention of morbidity and mortality in mechanically ventilated newborn infants

Not enough evidence to show the effect of permissive hypercapnia compared to routine ventilation for preterm babies needing mechanical ventilation. Sometimes preterm babies need help from a machine to breathe (mechanical ventilation). Very low carbon dioxide levels, produced by mechanical ventilation of the lungs are thought to cause lung damage and developmental problems. Hypercapnia (increasing the levels of carbon dioxide in the blood) is used for adults in critical care. It may also help newborn babies, especially those with lung damage on mechanical ventilation. The review of trials found there was not enough evidence to show the effect of permissive hypercania compared to routine ventilation for preterm babies. More research is needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Air versus oxygen for resuscitation of infants at birth

About 5 to 10% of infants need resuscitation at birth. Many experts recommend that these babies be resuscitated with 100% oxygen, but other experts think that normal room air is as good as or better than 100% oxygen. Too much oxygen can make breathing difficult for babies and can cause other problems such as problems with brain development, an eye condition (retinopathy of prematurity), and a lung condition (bronchopulmonary dysplasia). The authors of this Cochrane review questioned whether resuscitation with room air resulted in fewer deaths or disabilities than 100% oxygen. After searching the literature, they found five studies. There were a total of 1302 infants in these studies; 24% of them were premature. In the studies, fewer babies died when resuscitated with room air than with 100% oxygen. Many of the babies resuscitated with room air also got some oxygen as a supplement, making it difficult to compare the two groups. There were also other problems with the way the studies were carried out. The authors of the Cochrane review concluded that there is not enough evidence to recommend room air over 100% oxygen, or vice versa.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Early light reduction for preventing retinopathy of prematurity in very low birth weight infants

Retinopathy of prematurity (a common retinal neovascular disorder of premature infants) is a leading cause of childhood blindness worldwide. The cause of advanced retinopathy of prematurity and the way the disease develops are not fully understood. In the past many factors, such as the use of supplemental oxygen, excessive light exposure and hypoxia (lack of oxygen), have been suggested as possible causes. Light exposure has been investigated because experimental studies have demonstrated that intensive lighting can result in irreversible damage to the retina. However, the clinical studies conducted to date have shown conflicting results in terms of the effects of light in the development of the disease. Furthermore, studies have concluded that reduction of light exposure does not reduce the progression of retinopathy of prematurity.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Optical coherence tomography measurement of central retinal thickness to diagnose diabetic macular oedema

Diabetic macular oedema (DMO) is a thickening of the central part of the retina, the macula, that may affect people with diabetic retinopathy (DR). Diabetic retinopathy is a complication of diabetes in which the retina (a layer of tissue at the back of the eye) becomes progressively damaged. Diabetic macular oedema is detected by means of visual examination by an ophthalmologist. The most severe form of DMO ‐ clinically significant macular oedema (CSMO) ‐ is associated with sight loss in the long‐term. This condition is treatable. Laser photocoagulation (where a laser is used to burn off blood vessels) has been used for many years to reduce the risk of visual loss. More recently, antiangiogenic therapy (which prevents fluid leakage from retinal vessels) has been approved to try to improve vision.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: January 7, 2015

Intravitreal steroids for macular edema in people with diabetes

Macular edema, swelling of the center of the retina (the part of the eye responsible for our sharpest vision), is an important cause of poor vision in patients with diabetes. New forms of therapy are desirable because the current treatment including laser photocoagulation does not control all cases of diabetic macular edema (DME) and because laser therapy may destroy normal retinal tissue. Intraocular steroids in the form of intravitreal triamcinolone acetate injection (IVTA) and surgical implantation of fluocinolone acetonide (FAI) or dexamethasone drug delivery system (DDS) are promising new therapies. This systematic review included seven randomized clinical trials involving 632 eyes from five countries evaluating the effectiveness and safety of intravitreal steroids for treating DME. Two trials were at low risk of bias, one was at median risk of bias, two were at high risk of bias, and the remaining two had an unclear risk of bias. In this systematic review, the preponderance of data suggest a beneficial effect from IVTA. The average improvement in visual acuity was 7.5 letters more (‐0.15 LogMAR; 95% CI ‐0.21 to ‐0.09) in the IVTA treated eyes than in those treated with other therapies at three months (based on three trials), 11.5 letters more (‐0.23 LogMAR; 95% CI ‐0.33 to ‐0.13) at six months (two trials), 14.5 letters more (‐0.29 LogMAR; 95% CI ‐0.47 to ‐0.11) at nine months (one trial), and 5.7 letters more (‐0.11 LogMAR; 95% CI ‐0.20 to ‐0.03) at 24 months (one trial). Improved clinical outcomes were also reported in FAI and dexamethasone DDS trials. Elevation of intraocular pressure and cataract progression occur in both IVTA and implants treated eyes but appear manageable.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Paracetamol (acetaminophen) for prevention or treatment of pain in newborns

Background: Newborn infants have the ability to experience pain. Newborns treated in neonatal intensive care units are exposed to numerous painful procedures. Healthy newborns are exposed to pain if the birth process consists of assisted vaginal birth by vacuum extraction or by forceps and during blood sampling for newborn screening tests.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

Vitamin C and superoxide dismutase (SOD) for diabetic retinopathy

Diabetic retinopathy or eye disease is the leading cause of blindness in developed countries. Laser therapy currently is the primary means in the treatment of diabetic retinopathy. It nevertheless is a procedure which destroys important cells in the eye. There are theories that so‐called free radicals (substances which are thought to be harmful to body tissues) might be influenced by new medications to prevent or slow down vision loss in people with diabetes. Preliminary studies with vitamin C and 'superoxide dismutase' suggest that they may have an important role in treatment of diabetic retinopathy.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Local anaesthetic eye drops for prevention of pain in preterm infants undergoing screening for retinopathy of prematurity

Infants born less than 1500 g or less than 32 weeks are at increased risk of retinopathy of prematurity, a potentially blinding eye condition, and so have routine ophthalmological assessment. This process is a recognised source of pain and discomfort for preterm infants. This review highlights that retinopathy of prematurity is a painful examination and that instillation of local anaesthetic eyedrops immediately prior to examination of the eye is associated with a reduction in pain scores, as assessed by validated pain scores. Ongoing research is required to determine the optimum local anaesthetic eyedrop and other potentially important methods of reducing pain, including swaddling, and sucrose.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Supplemental oxygen for the treatment of prethreshold retinopathy of prematurity

Increased oxygen supplementation for babies with signs of worsening retinopathy of prematurity (ROP) may not prevent development of this eye disease, and may lead to lung complications. Very preterm babies are at risk of damage to their sight from ROP (retinopathy of prematurity). Oxygen plays a part in the development of ROP. The amount of oxygen babies receive in neonatal intensive care is very carefully monitored to try to lower the risk of ROP and limit the possibility of lung damage. One option is increasing the oxygen level to babies who are showing signs of worsening ROP. However, the review of the one available trial found that increased supplemental oxygen did not reduce the chances of ROP progressing, but may harm the lungs of babies showing signs of worsening ROP.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Superoxide dismutase for preventing chronic lung disease in mechanically ventilated preterm infants

Not enough evidence to show the effectiveness of superoxide dismutase in preventing chronic lung disease in premature babies. Chronic lung disease (CLD) is a common problem in preterm babies who are mechanically ventilated (machine assisted breathing). Free oxygen radicals are believed to cause CLD. Superoxide dismutase is an enzyme normally present in the body to provide a defence against free radicals but preterm infants do not have a sufficient supply to provide natural resistance. Giving superoxide dismutase to preterm infants may therefore prevent CLD. The review of trials found there is not enough evidence yet to show if this is effective. More research is needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Early versus late erythropoietin for preventing red blood cell transfusion in preterm and/or low birth weight infants

The number of red blood cells falls after birth in preterm infants due to the natural breakdown of erythrocytes and blood letting. Low levels of erythropoietin (EPO), a substance in the blood that stimulates red blood cell production in preterm infants, provide a rationale for the use of EPO to prevent or treat anaemia. A total of 262 infants born preterm have been enrolled in two studies of early versus late administration of EPO to prevent blood transfusions. There were no demonstrable benefits of early versus late administration of EPO with regards to reduction in the use of red blood cell transfusions, number of transfusions, the amount of red cells transfused or number of donor exposures per infant. However, the use of early EPO compared with late EPO administration increases the risk of retinopathy of prematurity, a serious complication in babies born before term. Currently, there is a lack of evidence that either treatment confers any substantial benefits with regard to any donor blood exposure, as many infants enrolled in both studies were exposed to donor blood prior to study entry, and early EPO increases the risk of retinopathy of prematurity. Neither early nor late administration of EPO is recommended.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Cycled light in the intensive care unit for preterm and low birth weight infants

Describe the effectiveness and safety of cycled light (approximately 12 hours of light on and 12 hours of light off) for growth in preterm infants at three and six months' corrected age. By exploring separate questions, we compared the effectiveness of cycled light with that of irregularly dimmed light or near darkness, and we compared cycled light with continuous bright light, for growth in preterm infants at three and six months' corrected age.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

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